X PHOTOS SECONDARY CRASH COUNTY* LOCATION REFERENCE 8 CR TRAFFIC CRASH REPORT *DENOTES MANDATORY FIELD FOR SUPPLEMENT REPORT * LOCAL INFORMATION X OH - OH - OH-P LOCALITY* - CITY - VILLAGE - TOWNSHIP ROUTE TYPE ROUTE NUMBER ROUTE TYPE ROUTE NUMBER REFERENCE POINT CR - INTERSECTION - MILE POST - HOUSE # DISTANCE FROM REFERENCE 0.5 OTHER PRIVATE PROPERTY DIRECTION FROM REFERENCE E- REPORTING AGENCY NAME * Hamilton Township LOCATION: CITY, VILLAGE, TOWNSHIP* Hamilton (Township of) - NORTH - EAST DISTANCE UNIT OF MEASURE - MILES - FEET - YARDS LOCATION OF FIRST HARMFUL EVENT - ON ROADWAY - ON SHOULDER - IN MEDIAN - ON ROADSIDE 5 - ON GORE 6 - OUTSIDE TRAFFIC WAY 7 - ON RAMP 8 - OFF RAMP 005 PREFIX - NORTH - EAST PREFIX - NORTH - EAST LOCATION ROAD NAME REFERENCE ROAD NAME (ROAD, MILEPOST, HOUSE #) ROUTE TYPE IR - INTERSTATE ROUTE (TP) US - FEDERAL US ROUTE SR - STATE ROUTE CR - NUMBERED COUNTY ROUTE TR - NUMBERED TOWNSHIP ROUTE 9 - CROSSOVER 0 - DRIVEWAY/ALLEY ACCESS - RAILWAY GRADE CROSSING - SHARED USE PATHS OR TRAILS - BIKE LANE - TOLL BOOTH AL - ALLEY AV - AVENUE BL - BOULEVARD CR - CIRCLE CT - COURT DR - DRIVE HE - HEIGHTS ROAD TYPE HW - HIGHWAY LA - LANE MP - MILEPOST OV - OVAL PK - PARKWAY PI - PIKE PL - PLACE NCIC * HIT/SKIP NUMBER OF UNITS 080 - SOLVED - UNSOLVED RD - ROAD SQ - SQUARE ST - STREET TE - TERRACE TL - TRAIL WA - WAY MANNER OF CRASH COLLISION/IMPACT - NOT COLLISION - REAR-TO-REAR BETWEEN 5 - BACKING TWO MOTOR 6 - ANGLE S IN TRANSPORT 7 - SIDESWIPE, SAME DIRECTION 8 - SIDESWIPE, OPPOSITE DIRECTION - REAR-END - HEAD-ON ROAD TYPE ROAD TYPE CRASH DATE / TIME* 0/9/09 08: LATITUDE DECIMAL DEGREES 9.78 LONGITUDE DECIMAL DEGREES -8.8777 ROADWAY INTERSECTION RELATED WITHIN INTERSECTION OR ON APPROACH WITHIN INTERCHANGE AREA ROADWAY DIVIDED DIRECTION OF TRAVEL - NORTH - EAST UNIT IN ERROR 98 - ANIMAL 99 - UNKNOWN CRASH SEVERITY - FATAL - SERIOUS INJURY SUSPECTED - MINOR INJURY SUSPECTED - INJURY POSSIBLE 5 - PROPERTY DAMAGE ONLY NUMBER OF APPROACHES MEDIAN TYPE - DIVIDED FLUSH MEDIAN ( < FEET ) - DIVIDED FLUSH MEDIAN ( FEET ) - DIVIDED, DEPRESSED MEDIAN - DIVIDED, RAISED MEDIAN (ANY TYPE) WORK ZONE RELATED WORKERS PRESENT LAW ENFORCEMENT PRESENT ACTIVE SCHOOL ZONE LIGHT CONDITION - DAYLIGHT - DAWN/DUSK - DARK - LIGHTED ROADWAY - DARK - ROADWAY NOT LIGHTED 5 - DARK - UNKNOWN ROADWAY LIGHTING WORK ZONE TYPE - LANE CLOSURE - LANE SHIFT/ CROSSOVER - WORK ON SHOULDER OR MEDIAN - INTERMITTENT OR MOVING WORK 5 - OTHER - CLEAR - CLOUDY LOCATION OF CRASH IN WORK ZONE WEATHER - BEFORE THE ST WORK ZONE WARNING SIGN - ADVANCE WARNING AREA - TRANSITION AREA - ACTIVITY AREA 5 - TERMINATION AREA - FOG, SMOG, SMOKE 8 - BLOWING SAND, SOIL, DIRT, SNOW - RAIN 5 - SLEET, HAIL 6 - SNOW 7 - SEVERE CROSSWINDS 9 - FREEZING RAIN OR FREEZING DRIZZLE CONTOUR - STRAIGHT LEVEL - STRAIGHT GRADE - CURVE LEVEL - CURVE GRADE 9 - OTHER /UNKNOWN - DRY - WET - SNOW CONDITIONS - ICE 5 - SAND, MUD, DIRT, OIL, GRAVEL 6 - WATER (STANDING, MOVING) 7 - SLUSH SURFACE - CONCRETE - BLACKTOP, BITUMINOUS, ASPHALT - BRICK/BLOCK - SLAG, GRAVEL, STONE 5 - DIRT 9 - OTHER / UNKNOWN NARRATIVE Unit 0 drove off the left side of the roadway. rolled over in a ditch, and struck a utility pole. CRASH REPORTED DATE / TIME 0/9/09 08: TOTAL TIME OTHER ROADWAY CLOSED INVESTIGATION TIME 0 0 TOTAL MINUTES DISPATCH DATE / TIME 0/9/09 08: OFFICER'S NAME* Schelldorf OFFICER'S BADGE NUMBER* ARRIVAL DATE / TIME 0/9/09 08:0 CHECKED OFFICER'S NAME* Viel, Sgt. Terry SCENE CLEARED DATE / TIME 0/9/09 09:56 CHECKED OFFICER'S BADGE NUMBER* 9 X REPORT POLICE AGENCY MOTORIST X SUPPLEMENT (CORRECTION OR ADDITION TO AN EXISTING REPORT SENT TO ODPS) PAGE OF
O W N E R V E H I C L E E V E N T S (s) UNIT # OWNER ( BUTLER, DAVID, V OWNER ( LP STATE OH COMMERCIAL UNIT TYPE SPECIAL FUNCTION DEFECTS NON- MOTORIST LOCATION ACTION LICENSE PLATE # GZD666 - TURN SIGNALS - HEAD LAMPS - TAIL LAMPS TYPE OF USE GOVERNMENT - PASSENGER CAR - PASSENGER VAN (MINIVAN) - SPORT UTILITY - PICK UP - INTERSECTION - MARKED CROSSWALK - INTERSECTION - UNMARKED CROSSWALK - INTERSECTION - OTHER IN EMERGENCY RESPONSE - BRAKES 5 - STEERING SAME AS DRIVER) # S 6 - VAN (9-5 SEATS) 7 - MOTORCYCLE -WHEELED 8 - MOTORCYCLE -WHEELED 9 - AUTOCYCLE 0 - MOPED OR MOTORIZED BICYCLE 5 - CARGO VAN - ALL TERRAIN (ATV/UTV) # OF TRAILING UNITS - NONE - TAXI - ELECTRONIC RIDE SHARING - SCHOOL TRANSPORT 5 - BUS - TRANSIT/COMMUTER - NON-CONTACT - NON-COLLISION - STRIKING - STRUCK 5 - BOTH STRIKING & STRUCK PRE-CRASH ACTIONS - NONE - FAILURE TO YIELD - RAN RED LIGHT - RAN STOP SIGN 5 - UNSAFE SPEED CONTRIBUTING 6 - IMPROPER TURN CIRCUMSTANCES 7 - LEFT OF CENTER SEQUENCE OF EVENTS 5 6 INSURANCE VERIFIED 9 0 INSURANCE COMPANY NONE - OVERTURN/ROLLOVER - FIRE/EXPLOSION - IMMERSION - JACKKNIFE 5 - CARGO / EQUIPMENT LOSS OR SHIFT 6 - EQUIPMENT FAILURE 5 - IMPACT ATTENUATOR / CRASH CUSHION 6 - BRIDGE OVERHEAD STRUCTURE 7 - BRIDGE PIER OR ABUTMENT 8 - BRIDGE PARAPET 9 - BRIDGE RAIL 0 - GUARDRAIL FACE SAME AS DRIVER) 8 WARDS CORNER RD, LOVELAND, OH, 50 COMMERCIAL CARRIER: NAME, ADDRESS, CITY, STATE, ZIP INTERLOCK DEVICE EQUIPPED CARGO BODY TYPE UNIT HIT/SKIP UNIT WAS OPERATING IN AUTONOMOUS MODE WHEN CRASH OCCURRED? - YES - NO AUTONOMOUS MODE LEVEL - NO CARGO BODY TYPE / NOT APPLICABLE - BUS - TOWING ANOTHER MOTOR 6 - BUS - CHARTER/TOUR 7 - BUS - INTERCITY 8 - BUS - SHUTTLE 9 - BUS - OTHER 0 - AMBULANCE - LOGGING 5 - INTERMODAL CONTAINER CHASSIS 6 - CARGOVAN /ENCLOSED BOX 6 - TIRE BLOWOUT - MIDBLOCK - MARKED CROSSWALK 5 - TRAVEL LANE - OTHER LOCATION 6 - BICYCLE LANE - STRAIGHT AHEAD - BACKING - CHANGING LANES - OVERTAKING/PASSING 5 - MAKING RIGHT TURN 6 - MAKING LEFT TURN 7 - MAKING U-TURN 8 - ENTERING TRAFFIC LANE 8 - FOLLOWING TOO CLOSE /ACDA 9 - IMPROPER LANE CHANGE 0 - IMPROPER PASSING - DROVE OFF ROAD - IMPROPER BACKING 7 - SEPARATION OF UNITS 8 - RAN OFF ROAD RIGHT 9 - RAN OFF ROAD LEFT 0 - CROSS MEDIAN - CROSS CENTERLINE - OPPOSITE DIRECTION OF TRAVEL 5 - MEDIAN CONCRETE BARRIER 6 - MEDIAN OTHER BARRIER 7 - TRAFFIC SIGN POST FIRST HARMFUL EVENT IDENTIFICATION # MZU55P6XUJ97 INSURANCE POLICY # US DOT # WEIGHT GVWR/GCWR - 0K LBS. - 0,00-6K LBS. - > 6K LBS. - GOLF CART - SNOWMOBILE - SINGLE UNIT TRUCK 5 - SEMI-TRACTOR 6 - FARM EQUIPMENT 7 - MOTORHOME 0 - NO AUTOMATION - DRIVER ASSISTANCE - PARTIAL AUTOMATION - FIRE - MILITARY - POLICE - PUBLIC UTILITY 5 - CONSTRUCTION EQUIP. 7 - GRAIN/CHIPS/GRAVEL 8 - POLE 9 - CARGO TANK 0 - FLAT BED 7 - WORN OR SLICK TIRES 9 - MOTOR TROUBLE 8 - TRAILER EQUIPMENT DEFECTIVE 7 - SHOULDER/ROADSIDE 8 - SIDEWALK 9 - MEDIAN/CROSSING ISLAND 9 - LEAVING TRAFFIC LANE 0 - PARKED - SLOWING OR STOPPED IN TRAFFIC - DRIVERLESS - NEGOTIATING A CURVE - ENTERING OR CROSSING SPECIFIED LOCATION - IMPROPER START FROM A PARKED - STOPPED OR PARKED ILLEGALLY 5 - SWERVING TO AVOID 6 - WRONG WAY 7 - VISION OBSTRUCTION 5 - PEDALCYCLE 6 - RAILWAY 7 - ANIMAL - FARM 8 - ANIMAL - DEER MOST HARMFUL EVENT 0 - DISABLED FROM PRIOR ACCIDENT MAKE MERCURY COLOR BLK MODEL MOUNTAINEER TOWED : COMPANY NAME PHIPPS HAZARDOUS MATERIAL MATERIAL CLASS # PLACARD ID # RELEASED PLACARD 8 - LIMO (LIVERY ) 9 - BUS (6+ PASSENGERS) 0 - OTHER - HEAVY EQUIPMENT - ANIMAL WITH RIDER OR ANIMAL-DRAWN 6 - FARM 7 - MOWING 8 - SNOW REMOVAL 9 - TOWING 0 - SAFETY SERVICE PATROL 0 - DRIVEWAY ACCESS - SHARED USE PATHS OR TRAILS - FIRST RESPONDER AT INCIDENT SCENE 5 - WALKING, RUNNING, JOGGING, PLAYING 6 - WORKING 7 - PUSHING 8 - APPROACHING OR LEAVING - PEDESTRIAN/SKATER - WHEELCHAIR (ANY TYPE) 5 - OTHER NON-MOTORIST 6 - BICYCLE 7 - TRAIN 9 - STANDING 0 - OTHER NON-MOTORIST 8 - OPERATING DEFECTIVE EQUIPMENT 9 - LOAD SHIFTING /FALLING/SPILLING 0 - IMPROPER CROSSING - LYING IN ROADWAY - NOT DISCERNIBLE NON-COLLISION - DOWNHILL RUNAWAY 9 - ANIMAL -OTHER - OTHER NON-COLLISION 0 - MOTOR IN - PEDESTRIAN TRANSPORT - PARKED MOTOR - WORK ZONE MAINTENANCE EQUIPMENT COLLISION WITH FIXED OBJECT - STRUCK - GUARDRAIL END - PORTABLE BARRIER 8 - OVERHEAD SIGN POST 9 - LIGHT / LUMINARIES 5 - EMBANKMENT 6 - FENCE - MEDIAN CABLE BARRIER SUPPORT 7 - MAILBOX - MEDIAN GUARDRAIL 0 - UTILITY POLE 8 - TREE BARRIER - OTHER POST, POLE 9 - FIRE HYDRANT OR SUPPORT - CULVERT - CURB - DITCH OWNER PHONE:INCLUDE AREA CODE ( COMMERCIAL CARRIER PHONE: INCLUDE AREA CODE 50 - WORK ZONE MAINTENANCE EQUIPMENT 5 - WALL YEAR 999 - CONDITIONAL AUTOMATION - HIGH AUTOMATION 5 - FULL AUTOMATION 99 - UNKNOWN OR HIT/SKIP - MAIL CARRIER - DUMP - CONCRETE MIXER - AUTO TRANSPORTER - GARBAGE/REFUSE 5--908 9 - UNKNOWN SAME AS DRIVER) - STANDING OUTSIDE DISABLED - OPENING DOOR INTO ROADWAY 99 - OTHER IMPROPER ACTION - STRUCK FALLING, SHIFTING CARGO OR ANYTHING SET IN MOTION A MOTOR - OTHER MOVABLE OBJECT 5 - BUILDING 5 - TUNNEL 5 - OTHER FIXED OBJECT - NONE - MINOR DAMAGE FROM DAMAGE SCALE 9 - UNKNOWN DAMAGED AREA(S) INDICATE ALL THAT APPLY - NO DAMAGE [ 0 ] - TOP [ ] TRAFFICWAY FLOW - ONE-WAY - TWO-WAY # OF THROUGH LANES ON ROAD UNIT SPEED 5 - FUNCTIONAL DAMAGE - DISABLING DAMAGE - UNIT NOT AT SCENE [ 6 ] 6 - UNDERCARRIAGE [ ] X - ALL AREAS [ 5 ] TRAFFIC CONTROL - ROUNDABOUT - SIGNAL - FLASHER UNIT / NON-MOTORIST DIRECTION 8 5 TO POSTED SPEED 5 D A M A G E INITIAL POINT OF CONTACT 0 - NO DAMAGE - - REFER TO UNIT DIAGRAM - TOP T R A F F I C - NORTH - EAST - UNDERCARRIAGE 5 - NOT AT SCENE 99 - UNKNOWN DETECTED SPEED - STATED / ESTIMATED SPEED - CALCULATED / EDR - UNDETERMINED - STOP SIGN 5 - YIELD SIGN RAIL GRADE CROSSING - NOT INVLOVED 6 - NO CONTROL - INVOLVED-ACTIVE CROSSING - INVOLVED-PASSIVE CROSSING 5 - NORTHEAST 6 - NORTHWEST 7 - SOUTHEAST 8 - SOUTHWEST PAGE OF
UNIT # DATE OF BIRTH AGE GENDER 8 WARDS CORNER RD, LOVELAND, OH, 50 INJURIES BUTLER, DAVID, V INJURED EMS AGENCY (NAME) MEDIC 76 OL STATE OPERATOR LICENSE NUMBER OH RN0885 INJURED TO: MEDICAL FACILITY (NAME, CITY) BETHESDA NORTH OFFENSE CHARGED 5.0 ENDORSEMENT RESTRICTION SELECT UP TO DRIVER DISTRACTED LOCAL CODE / DRUG SUSPECTED OTHER DRUG MARIJUANA SAFETY EQUIPMENT OFFENSE DESCRIPTION 06/05/96 5--908 OPERATING WITHOUT REASO CONDITION STATUS TEST TYPE. VALUE AIR BAG USAGE 55 EJECTION CITATION NUMBER EP097 DRUG TEST(S) STATUS M TRAPPED TYPE RESULTS SELECT UP TO UNIT # DATE OF BIRTH AGE GENDER OL STATE EMS AGENCY (NAME) INJURED TO: MEDICAL FACILITY (NAME, CITY) SAFETY EQUIPMENT OPERATOR LICENSE NUMBER OFFENSE CHARGED LOCAL CODE ENDORSEMENT RESTRICTION SELECT UP TO DRIVER DISTRACTED / DRUG SUSPECTED OTHER DRUG MARIJUANA OFFENSE DESCRIPTION CITATION NUMBER CONDITION TEST DRUG TEST(S) STATUS TYPE VALUE. STATUS TYPE RESULTS SELECT UP TO UNIT # DATE OF BIRTH AGE GENDER OL STATE - FATAL INJURIES - SUSPECTED SERIOUS INJURY - SUSPECTED MINOR INJURY - POSSIBLE INJURY 5 - NO APPARENT INJURY - NOT TRANSPORTED /TREATED AT SCENE - EMS - POLICE - NONE - SHOULDER BELT ONLY - LAP BELT ONLY - SHOULDER & LAP BELT 5 - CHILD RESTRAINT SYSTEM - FORWARD FACING 6 - CHILD RESTRAINT SYSTEM - REAR FACING 7 - BOOSTER SEAT 8 - HELMET 9 - PROTECTIVE PADS (ELBOWS, KNEES, ETC) 0 - REFLECTIVE CLOTHING - LIGHTING - PEDESTRIAN / BICYCLE ONLY EMS AGENCY (NAME) INJURED TO: MEDICAL FACILITY (NAME, CITY) SAFETY EQUIPMENT OPERATOR LICENSE NUMBER OFFENSE CHARGED LOCAL CODE INJURIES SAFETY EQUIPMENT ENDORSEMENT RESTRICTION SELECT UP TO DRIVER DISTRACTED - FRONT - LEFT SIDE (MOTORCYCLE DRIVER) - FRONT - MIDDLE - FRONT - RIGHT SIDE - SECOND - LEFT SIDE (MOTORCYCLE PASSENGER) 5 - SECOND - MIDDLE 6 - SECOND - RIGHT SIDE 7 - THIRD - LEFT SIDE (MOTORCYCLE SIDE CAR) 8 - THIRD - MIDDLE 9 - THIRD - RIGHT SIDE 0 - SLEEPER SECTION OF TRUCK CAB - PASSENGER IN OTHER ENCLOSED CARGO AREA (NON-TRAILING UNIT, BUS, PICK-UP WITH CAP) - PASSENGER IN UNENCLOSED CARGO AREA - TRAILING UNIT - RIDING ON EXTERIOR (NON-TRAILING UNIT) 5 - NON-MOTORIST AIR BAG / DRUG SUSPECTED - NOT DEPLOYED - DEPLOYED FRONT - DEPLOYED SIDE - DEPLOYED BOTH FRONT/SIDE 5 - NOT APPLICABLE 9 - DEPLOYMENT UNKNOWN EJECTION - NOT EJECTED - PARTIALLY EJECTED - TOTALLY EJECTED - NOT APPLICABLE TRAPPED - NOT TRAPPED - EXTRICATED MECHANICAL MEANS - FREED NON-MECHANICAL MEANS OTHER DRUG MARIJUANA OFFENSE DESCRIPTION CITATION NUMBER CONDITION TEST DRUG TEST(S) OL RESTRICTION(S) STATUS TYPE VALUE. DRIVER DISTRACTION - CLASS A - INTERLOCK - NOT DISTRACTED DEVICE - MANUALLY OPERATING AN - CLASS B - CDL INTRASTATE ONLY ELECTRONIC - CLASS C - CORRECTIVE LENSES COMMUNICATION DEVICE - FARM WAIVER (TEXTING, TYPING, - REGULAR CLASS 5 - EXCEPT CLASS A BUS DIALING) (OHIO = D) 6 - EXCEPT CLASS A - TALKING ON HANDS-FREE & CLASS B BUS COMMUNICATION DEVICE 5 - M/C MOPED ONLY 7 - EXCEPT TRACTOR-TRAILER - TALKING ON HAND-HELD 6 - NO VALID OL 8 - INTERMEDIATE LICENSE COMMUNICATION DEVICE RESTRICTIONS 5 - OTHER ACTIVITY WITH AN 9 - LEARNER'S PERMIT ELECTRONIC DEVICE OL ENDORSEMENT RESTRICTIONS 6 - PASSENGER 0 - LIMITED TO DAYLIGHT 7 - OTHER DISTRACTION H - HAZMAT ONLY INSIDE THE M - MOTORCYCLE - LIMITED TO EMPLOYMENT 8 - OTHER DISTRACTION P - PASSENGER - LIMITED - OTHER OUTSIDE THE - MECHANICAL DEVICES N - TANKER (SPECIAL BRAKES, HAND CONDITION Q - MOTOR SCOOTER CONTROLS, OR OTHER ADAPTIVE DEVICES) - APPARENTLY NORMAL R - THREE-WHEEL - MILITARY S ONLY - PHYSICAL IMPAIRMENT MOTORCYCLE 5 - MOTOR S - EMOTIONAL (E.G., S - SCHOOL BUS WITHOUT AIR BRAKES DEPRESSED, ANGRY, 6 - OUTSIDE MIRROR DISTURBED) T - DOUBLE & TRIPLE 7 - PROSTHETIC AID TRAILERS - ILLNESS 8 - OTHER 5 - FELL ASLEEP, FAINTED, X - TANKER / HAZMAT FATIGUED, ETC. 6 - UNDER THE INFLUENCE OF GENDER MEDICATIONS / DRUGS / F - FEMALE M - MALE U - OTHER / UNKNOWN STATUS TYPE RESULTS SELECT UP TO TEST STATUS - NONE GIVEN - TEST REF - TEST GIVEN, CONTAMINATED SAMPLE / UNUSABLE - TEST GIVEN, RESULTS KNOWN 5 - TEST GIVEN, RESULTS UNKNOWN TEST TYPE - NONE - BLOOD - URINE - BREATH 5 - OTHER DRUG TEST TYPE - NONE - BLOOD - URINE - OTHER DRUG TEST RESULT(S) - AMPHETAMINES - BARBITURATES - BENZODIAZEPINES - CANNABINOIDS 5 - COCAINE 6 - OPIATES / OPIOIDS 7 - OTHER 8 - NEGATIVE RESULTS PAGE OF
/ WITNESS ADDENDUM UNIT # DATE OF BIRTH AGE GENDER EMS AGENCY (NAME) INJURED TO: MEDICAL FACILITY (NAME, CITY) SAFETY EQUIPMENT UNIT # DATE OF BIRTH AGE GENDER EMS AGENCY (NAME) INJURED TO: MEDICAL FACILITY (NAME, CITY) SAFETY EQUIPMENT UNIT # DATE OF BIRTH AGE GENDER EMS AGENCY (NAME) INJURED TO: MEDICAL FACILITY (NAME, CITY) SAFETY EQUIPMENT UNIT # DATE OF BIRTH AGE GENDER EMS AGENCY (NAME) INJURED TO: MEDICAL FACILITY (NAME, CITY) SAFETY EQUIPMENT INJURIES - FATAL - SUSPECTED SERIOUS INJURY - SUSPECTED MINOR INJURY - POSSIBLE INJURY 5 - NO APPARENT INJURY INJURED - NOT TRANSPORTED / TREATED AT SCENE - EMS - POLICE SAFETY EQUIPMENT AIR BAG USAGE - NONE - - SHOULDER BELT ONLY - LAP BELT ONLY - SHOULDER & LAP BELT 5 - CHILD RESTRAINT SYSTEM - FORWARD FACING 6 - CHILD RESTRAINT SYSTEM - REAR FACING 7 - BOOSTER SEAT 8 - HELMET 9 - PROTECTIVE PADS (ELBOWS, KNEES, ETC) 0 - REFLECTIVE CLOTHING - LIGHTING - PEDESTRIAN / BICYCLE ONLY - FRONT - LEFT SIDE (MOTORCYCLE DRIVER) - FRONT - MIDDLE - FRONT - RIGHT SIDE - SECOND - LEFT SIDE (MOTORCYCLE PASSENGER) 5 - SECOND - MIDDLE 6 - SECOND - RIGHT SIDE 7 - THIRD - LEFT SIDE (MOTORCYCLE SIDE CAR) 8 - THIRD - MIDDLE 9 - THIRD - RIGHT SIDE 0 - SLEEPER SECTION OF TRUCK CAB - PASSENGER IN OTHER ENCLOSED CARGO AREA (NON-TRAILING UNIT SUCH AS A BUS, PICK-UP WITH CAP) - PASSENGER IN UNENCLOSED CARGO AREA - TRAILING UNIT - RIDING ON EXTERIOR (NON-TRAILING UNIT) 5 - NON-MOTORIST - NOT DEPLOYED - DEPLOYED FRONT - DEPLOYED SIDE - DEPLOYED BOTH FRONT/SIDE 5 - NOT APPLICABLE 9 - DEPLOYMENT UNKNOWN - NOT EJECTED - PARTIALLY EJECTED - TOTALLY EJECTED - NOT APPLICABLE - NOT TRAPPED EJECTION TRAPPED - EXTRICATED MECHANICAL MEANS - FREED NON-MECHANICAL MEANS DATE OF BIRTH AGE GENDER WITNESS MAGGARD, SUSAN, C 6 MORROW MEADOW DR, MORROW, OH, 55 08/0/97 5-907-8 5 F DATE OF BIRTH AGE GENDER WITNESS DATE OF BIRTH AGE GENDER WITNESS PAGE OF
OHIO TRAFFIC ACCIDENT - OH NARRATIVE IN COUNTY OF Warren County REPORTING AGENCY Hamilton Township ACCIDENT LOCATION 005 DATE OF CRASH 0/9/09 Damage To Utility Pole POLE # W9E Duke Energy Gest St Cincinnati, OH 50 (800) 5-6900 OFFICERS SIGNATURE BADGE NO.
OHIO TRAFFIC ACCIDENT - OH DIAGRAM IN COUNTY OF Warren County REPORTING AGENCY Hamilton Township ACCIDENT LOCATION 005 Date Of Crash 0/9/09 OFFICERS SIGNATURE BADGE NO.